Provider Demographics
NPI:1356459119
Name:HCC OF CARLISLE, P.C.
Entity type:Organization
Organization Name:HCC OF CARLISLE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHANON
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLCOMB
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:717-240-1277
Mailing Address - Street 1:1 VALLEY ST
Mailing Address - Street 2:SUITE 106
Mailing Address - City:CARLISLE
Mailing Address - State:PA
Mailing Address - Zip Code:17013-3193
Mailing Address - Country:US
Mailing Address - Phone:717-240-1277
Mailing Address - Fax:717-240-1278
Practice Address - Street 1:1 VALLEY ST
Practice Address - Street 2:SUITE 106
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17013-3193
Practice Address - Country:US
Practice Address - Phone:717-240-1277
Practice Address - Fax:717-240-1278
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-006965-L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAU68390Medicare UPIN
PAHO 000229Medicare ID - Type Unspecified